Klett-Kimble, Bethany Marie

Klett-Kimble, Bethany Marie is an individual health care provider with primary practice located at 835 S Van Buren St , Green Bay WI 54301-3526. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is her primary health care specialty. Klett-Kimble, Bethany Marie can be contacted via phone (920) 433-0111.

Contact Information

Primary practice address
835 S Van Buren St Green Bay WI 54301-3526
Phone: (920) 433-0111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 75204 Wisconsin
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 75204 Wisconsin

Profile Details

NPI number 1679068381
LBN Legal business name Klett-Kimble, Bethany Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2018
Last updated Jul 10th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679068381 NPPES
Wisconsin MEDICAID 1679068381

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